Nursing

1
Nursing Midwifery Workload and Workforce
Planning

• Planning and Managing Staff Resources

2
A roster for nursing and midwifery staff is a
plan showing on and off duty periods for staff
within a defined area such as a ward or community
locality. The plan should reflect the peaks and
troughs of expected workload, ensuring staff are
available at the times they are required

• Rostering affects
• patient care
• Budgets
• Staff morale/ wellbeing

• Rostering requires skills in
• planning
• knowledge of expected workload activity
• knowledge of patient care
• collaboration
• communication

3
Methods

• self rostering
• computerised rostering (e-roster)
• rotational roster
• manual off duty

4
Principles of Rostering

• Whatever method is used however, the following
  principles should apply
• the rota should be available to staff at least
  four weeks in advance and modified to take into
  account unexpected events
• methods of rostering and shift patterns should be
  reviewed regularly
• the rota should be kept as a legal document as it
  shows who was working when
• rota and shift patterns should reflect European
  Work Time Directives which should be incorporated
  into hospital policies

5
Rostering Protocols

• Rostering should be supported by clear protocols
  to guide decision-making. Such protocols should
  include rules about
• minimum and maximum skill levels
• minimum and maximum staffing numbers
• procedures to be followed in the event of
  unplanned absences
• procedures for the use of bank and agency staff
• maintenance records
• audit requirements
• length of shifts
• nature of individuals shift patterns

6
Why Modernise our Rostering Practices?

• Social Change
• society demands greater efficiency
• increased patient choice in the health care
  system
• public more informed
• Political and Professional Change
• recent policy documents
• Workforce change
• staff want greater flexibility and work/life
  balance is becoming more important
• improved working conditions
• greater involvement in decisions which affect
  them

7
Why Modernise our Rostering Practices? (2)

• Technological Change
• IT gives opportunity to modernise
• Organisational Change
• SCNs, SCMs TLs to become more strategic
• drive for greater empowerment of workforce
• need to proceed on a partnership basis

8
Building an Effective Roster

• The principles of accountability in rostering
  according to the Office for Health Management
  (2003) are

• patient and service needs come first
• involve staff as much as possible
• consider staff competence
• be fair and flexible
• agreeing for one person sets a precedent
• think twice
• communicate verbally and in writing
• then communicate again!

9
Framework For Building An Effective Roster

1. Matching demand with an appropriate supply of
   nurses
2. Allocating a units budgeted WTE
3. Determining and allocating a suitable mix of
   competency and experience

10
Building An Effective Roster

• To roster an appropriate number of staff you will
  need to be aware of
• WTE establishment for your ward / department
• predicted absence allowance (22.5) Indicative
  breakdown
• 14.5 annual leave
• 4 sickness
• 1 maternity leave
• 2 study leave
• 1 other annual leave
• the numbers and skill mix of staff required to
  meet workload peaks and troughs throughout the
  day and / or across the week
• local protocols / guidance

11
Planned Time Out and Absenteeism

• difficult to estimate accurately
• nationally agreed minimum predicted absence
  allowance of 22.5 built into in patient staffing
  budget
• unplanned absences through employee sickness
  disrupt service provision and increases costs of
  providing services
• patterns may indicate that there are aspects of
  the working environment that require management
  attention
• HR employment policies

12
Use of Agency and Bank Staff

• The Nationally Co-ordinated Nurse Bank
  Arrangement Report and Action Plan
• (SEHD, 2005c)
• analysed the pattern of usage of bank nurses
• NHS boards should set targets on an annual basis
  to reduce the proportion of complementary staff
  utilised from agency as a percentage of the total
  nurse staff deployment
• ensure policies and procedures are in place
• A Good Practice Guide in the Use of Supplementary
  Staffing
• (Scottish Government, 2007c)
• highlights the organisational policies and
  responsibilities of those who manage the
  nurse/midwife staffing resource
• provides rationale and means of assessing the
  ward, care setting or organisational position